Southwest Internal Medicine Forms
We are currently not accepting new patients. If you would like, please complete the New Patient Screening form below, return it to us and we will contact you if we have an opening, or check back here to for updates. You may return it to us by Fax – (888) 832 1367 – or drop it by our office at 111 N Park, Cortez.
Upon being accepted to the practice, please complete the New Patient Packet, and return it to us by Fax (888 832 1367) or drop it by our office at 111 N Park, Cortez.
The Records Release Form can be used to request records from our office, either to “Self” or another provider’s office.